中国不同风险人群心血管疾病的膳食和体力活动状况

崔晴梅; 李建新; 曹杰; 刘芳超; 黄克勇; 陈恕凤; 陈纪春; 黄建凤; 顾东风; 鲁向锋

doi:10.16462/j.cnki.zhjbkz.2022.03.002

中国不同风险人群心血管疾病的膳食和体力活动状况

doi: 10.16462/j.cnki.zhjbkz.2022.03.002

100037 北京，北京协和医学院国家心血管病中心，中国医学科学院阜外医院流行病研究部，中国医学科学院心血管流行病学重点实验室

基金项目:

国家重点研究计划 2017YFC0211700

国家重点研究计划 2016YFC0206503

国家重点研究计划 2018YFC1311703

中国医学科学院医学与健康科技创新工程 2017-I2M-1-004

中国医学科学院医学与健康科技创新工程 2019-I2M-2-003

详细信息

通讯作者:
鲁向锋，E-mail: xiangfenglu@sina.com

中图分类号: R181.2
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出版历程
- 收稿日期: 2021-03-13
- 修回日期: 2021-05-01
- 网络出版日期: 2022-03-17
- 刊出日期: 2022-03-10

Diet and physical activity in Chinese people with different risks of cardiovascular disease

Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China

Funds:

National Key Research & Development Program of China 2017YFC0211700

National Key Research & Development Program of China 2016YFC0206503

National Key Research & Development Program of China 2018YFC1311703

Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences 2017-I2M-1-004

Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences 2019-I2M-2-003

More Information

Corresponding author: LU Xiang-feng, E-mail: xiangfenglu@sina.com

摘要

摘要: 目的评价中国不同风险人群心血管疾病(cardiovascular disease, CVD)理想生活方式中膳食和体力活动的分布状况，为CVD的防治提供科学依据。方法利用来自全国22 220名35~74岁既往无CVD个体的调查资料，使用中国动脉粥样硬化性心血管疾病风险预测(prediction for atherosclerotic cardiovascular disease risk in China, China-PAR)模型进行10年CVD风险评估并分组： < 5%为低风险，5%~ < 10%为中风险，≥10%为高风险。比较不同风险人群中膳食(蔬菜水果、鱼类、红肉、豆制品和茶)和体力活动指标分布情况。结果中国35~74岁人群中，10年CVD风险低、中、高风险者分别占75.6%、14.9%和9.4%。与女性相比，男性的膳食(56.6% vs. 75.6%)、体力活动(46.2% vs. 57.6%)理想比例均较高(均有P < 0.05)。蔬菜水果和鱼类理想率均随着CVD风险水平的升高呈现下降趋势(均有P < 0.05)，其中水果和鱼类摄入不足在CVD高风险和低风险人群中差异最大。体力活动理想率随风险水平升高呈现下降趋势(P < 0.001)，其中女性高、低风险组体力活动理想率差异较大(28.7% vs. 48.4%)。结论 CVD高风险组人群的膳食、体力活动理想率最低，女性尤为严重，应积极引导高风险人群摄入蔬菜水果和鱼类，参与体育锻炼。
- 心血管疾病 /
- 心血管疾病风险 /
- 膳食 /
- 体力活动
Abstract: Objective To describe the distribution of two ideal health behaviors: diet and physical activity in Chinese adults with cardiovascular disease (CVD) risks, and to further provide evidence for CVD prevention. Methods The study included 22 220 adults aged 35 to 74 years without CVD from 14 Provinces or cities in China. The 10-year CVD risks for all participants were estimated using the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) equations, and participants were subsequently divided into low (< 5%), moderate (5- < 10%) and high risk (≥10%) groups. Sex-specific distribution of five ideal diet metrics (vegetables and fruits, fish, red meat, soybean products, and tea) and physical activity were compared among participants at different CVD risk groups. Results Among Chinese population aged 35-74 years, there were 75.6%, 14.9% and 9.4% of participants with low, moderate, and high risk of 10-year CVD, respectively. Compared with women, the ideal proportion of male diet (56.6% vs. 75.6%) physical activity (46.2% vs. 57.6%) was higher(all P < 0.05). Ideal intake of vegetable, fruits and fish decreased with the 10-year CVD risk (P < 0.05) in both sexes. Inadequate intake of fruit and fish among participants with high CVD risk was the most serious problem. A decreasing trend was observed for the ideal physical activity with the 10-year CVD risk (P < 0.001). Women with high CVD risk had substantial difference of ideal physical activity than those with low CVD risk (28.7% vs. 48.4%). Conclusion Low prevalence of ideal diet and physical activity occurred in population with high 10-year CVD risk in China, especially in women. It is imperative to implement healthy lifestyle measures among high-risk population, such as enhancing intake of vegetable, fruits, fish and promoting physical activity.
- Cardiovascular disease /
- CVD risk /
- Diet /
- Physical activity

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图 1 不同CVD风险组理想生活方式构成

Figure 1. Percentage of ideal health behaviors according to CVD risk categories

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表 1 10年CVD不同风险人群基线特征[n (%)]

Table 1. Baseline characteristics of participants with different 10-year CVD risks [n (%)]

特征	低风险(n=16 804)	中风险(n=3 317)	高风险(n=2 099)	合计(N=22 220)	F/χ²值	P值
年龄(岁)	45.5±7.2	57.4±7.8 ^a	61.9±7.8 ^a	48.9±9.5	7 254.21	< 0.001
男性	7 299(43.4)	1 891(57.0) ^a	1 367(65.1) ^a	10 557(47.5)	493.06	< 0.001
北方	6 626(39.4)	1 934(58.3) ^a	1 584(75.5) ^a	10 144(45.7)	1 228.07	< 0.001
城市	7 826(46.6)	1 600(48.2)	1 011(48.2)	10 437(47.0)	4.41	0.110
吸烟	4 593(27.3)	1 280(38.6) ^a	866(41.3) ^a	6 739(30.3)	297.14	< 0.001
饮酒	3 888(23.2)	873(26.3) ^a	581(27.8) ^a	5 342(24.0)	32.75	< 0.001
高中及以上文化程度	5 599(33.6)	783(24.0) ^a	432(21.0) ^a	6 814(30.7)	225.04	< 0.001
年收入≥6 000(元/年)	5 152(31.0)	1 004(30.5)	634(30.6)	6 790(30.6)	0.41	0.813
BMI(kg/m²)	23.1±3.3	24.4±3.9 ^a	25.2±3.9 ^a	23.5±3.5	512.82	< 0.001
SBP(mm Hg)	116.9±14.2	137.3±17.6 ^a	154.1±23.1 ^a	123.4±20.0	6 696.99	< 0.001
DBP(mm Hg)	75.9±9.8	83.8±11.9 ^a	88.5±14.1 ^a	78.2±11.4	1 888.97	< 0.001
FPG(mmol/L)	5.1±1.1	5.6±1.8 ^a	6.2±2.3 ^a	5.3±1.4	720.08	< 0.001
TC(mmol/L)	4.8±0.9	5.1±1.0 ^a	5.2±1.1 ^a	4.8±1.0	329.02	< 0.001
理想生活方式
吸烟	11 992(71.4)	1 986(59.9) ^a	1 193(56.8) ^a	15 171(68.3)	308.92	< 0.001
膳食	11 254(67.0)	2 079(62.7) ^a	1 252(59.6) ^a	14 585(65.6)	59.55	< 0.001
体力活动	9 161(54.5)	1 524(46.0) ^a	783(37.3) ^a	11 468(51.6)	271.50	< 0.001
BMI(kg/m²)	12 534(74.6)	1 929(58.2) ^a	1 000(47.6) ^a	15 463(69.6)	881.23	< 0.001
注：连续变量表示为(x±s)，采用单因素方差分析比较组间差异，统计量为F值；分类变量表示为[n (%)]，采用χ²检验比较组间差异，统计量为χ²值；^a与低风险组比较P < 0.05。

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表 2 男女性不同CVD风险组膳食和体力活动因素分布

Table 2. Distribution of diet and physical activity according to CVD risk categories among men and women

项目	男性						女性
项目	低风险(%)	中风险(%)	高风险(%)	合计(%)	χ²_趋势值	P_趋势值	低风险(%)	中风险(%)	高风险(%)	合计(%)	χ²_趋势值	P_趋势值
理想膳食^ab	78.1	71.8	66.5	75.6	51.51	< 0.001	59.6	46.6	38.1	56.6	111.56	< 0.001
蔬菜水果^ab	64.5	62.0	56.5	63.0	19.56	< 0.001	66.8	62.1	57.1	65.6	23.30	< 0.001
蔬菜^a	78.4	69.8	54.6	74.0	185.94	< 0.001	78.0	62.9	53.1	74.7	167.89	< 0.001
水果^a	31.1	24.3	16.3	27.8	87.17	< 0.001	29.2	22.7	16.4	28.0	44.27	< 0.001
鱼类^ab	55.9	36.3	27.5	48.6	255.26	< 0.001	47.1	29.5	18.2	42.9	224.81	< 0.001
豆制品^b	2.1	2.6	2.7	2.2	1.50	0.221	1.3	1.9	1.7	1.4	1.31	0.253
红肉^ab	56.2	62.7	66.0	58.6	31.42	< 0.001	45.6	39.8	37.0	44.3	19.47	< 0.001
茶^b	40.6	39.7	38.0	40.1	2.01	0.157	15.8	14.4	18.1	15.8	1.04	0.307
体力活动^ab	58.6	58.4	52.0	57.6	12.07	< 0.001	48.4	39.1	28.7	46.2	84.98	< 0.001
注：各风险组变量均校正年龄。^a男女性不同风险组人群中，膳食因素、体力活动组间差异比较均有P < 0.05；^b男女性总体膳食、体力活动因素差异比较均有P < 0.05。

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